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Mental retardation
For the psychiatrist who is managing medications, and is
part of a team of other mental health professionals, when
accepting a patient with FASD, they will very often ®nd
themselves caring for an individual with chronic and
persistent mental illness. The symptomatology and the
response to medication may wax and wane over time as
the individual grows and matures, passing physiologically
into different phases of their life. In addition to
concrete symptom relief, being able to support the
patient and family through crisis is one of the most
important and meaningful tools that psychiatrists and
other mental health providers have at their disposal.
Even if the treatment is not as effective as hoped,
helping the family to avoid `burn-out', maintain hope
and enthusiasm for the individual's welfare, and entering
into a partnership with them to lead this individual to
their best outcome, are all skills that are important to
desperate parents [44].
When approaching psychopharmacological treatment,
the psychiatrist needs to be cognizant of common
physical problems that can complicate one's ability to
treat these individuals safely (cardiac problems, possibly
lowered seizure threshold, optic nerve hypoplasia,
auditory and vestibular problems) as well as atypical
responses to commonly used medications. Approaching
carefully as in the treatment of other organic brain
syndromes is in order; especially in severely affected
individuals.
Conclusion
Mental health treatment research is understood to be
one of the most urgent areas in need of further
development. Better psychopharmacological approaches,
focused individual and group psychotherapy across a
number of domains (behavioral, social and cognitive)
need to be developed speci®cally for these individuals.
Disability criteria need to be broadened in each region,
to accommodate the recent neurodevelopmental data
demonstrating severe disability across a spectrum of
effects. Those with the full FAS criteria are just a small
proportion of those experiencing severe limitations in
functioning as a consequence of prenatal alcohol
exposure. The rather large number of individuals with
some alcohol-related disability, with and without dysmorphic
features, or mental retardation leaves the mental
health community worldwide with the great responsibility
of identifying and providing life-enhancing support,
understanding and treatment to this very needy
population.
Acknowledgements
The author wishes to thank Cynthia Keysor, PhD and Elaine Tierney,
MD for their assistance in preparing this manuscript.
References and recommended reading
Papers of particular interest, published within the annual period of review, have
been highlighted as:
. of special interest
.. of outstanding interest
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